Foods to avoid while breastfeeding

How do the options compare?

Options are compared on ACOG or MotherToBaby endorsement, size and quality of pregnancy-specific studies, dosing predictability, time-to-effect, and side-effect profile: the same axes an obstetric clinician would use.

• The one genuine avoid list is fish: king mackerel, marlin, orange roughy, shark, swordfish, Gulf of Mexico tilefish, and bigeye tuna carry the highest mercury levels for people who are pregnant or breastfeeding. 1
• Caffeine is a ceiling, not a cut: moderate amounts around 200 mg a day most likely will not affect your baby, though newborn and preterm babies are more sensitive. 2
• Alcohol is a timing question: with casual use such as one glass of wine or beer, waiting 2 to 2.5 hours per drink before nursing is the guidance. 3
• Red pepper is the only everyday food with case reports behind it, with skin rashes described in babies of parents who ate heavily spiced dishes, appearing about 12 hours after nursing. 4
• The positive side of the ledger is more specific than the avoid side: about 450 to 500 extra calories a day, fish two to three times a week, plenty of fluids, and possibly a continued prenatal multivitamin. 2
• LactMed lists 300 to 500 mg of caffeine a day as a commonly cited ceiling for breastfeeding parents, notes that European guidance favors a more conservative 200 mg, and reports that infant fussiness or poor sleep has mainly shown up at much higher intakes, around 10 or more cups of coffee a day. 5
• MotherToBaby's methylmercury fact sheet names the same high-mercury fish to limit (bigeye tuna, shark, king mackerel, swordfish, marlin, Gulf of Mexico tilefish, orange roughy) and recommends up to about 12 ounces a week of lower-mercury fish, mostly from the 'Best Choices' list. 6

Which option makes sense?

A comparison can include options that should be avoided or considered only in specific circumstances. Please consult your healthcare provider about the findings and cautions that apply to you.

Disclosure: Pregnancy Smart makes pregnancy supplements, though not in this category. This comparison is a plain description of the pregnancy evidence, not a sales page.